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4 Ways Unalloyed Fear Can Damage the Hospital Culture

Some hospital cultures promote confidence and risk-taking among employees while others create stress and anxiety, and this substantially affects the bottom line, says Brad Federman, president of Performancepoint in Memphis, Tenn. Here Mr. Federman identifies four ways unalloyed fear can destroy the work culture of a hospital, reducing efficiency and income.

1. Hiding from financial troubles. When the hospital starts losing money, the top executives hide in their offices and are not to be seen anywhere. Employees, left without any information, start getting very fearful and are distracted from doing their work. Mr. Federman found that hospitals that were in financial straits during the recession fared better if they were transparent about it.

2. Slamming a new idea. Someone presents an intriguing idea at a meeting. The leader of the meeting downplays the idea, fearful that if he accepts it too eagerly, others may not present their own ideas. He challenges the person who presented the idea, to the point where everyone is speechless. As a result, no one wants to present any idea, the exact opposite of what the leader wanted.

3. Tearing down a critic. If a well-meaning critic in the hospital is successfully silenced and even forced out of his job, the event immediately enters the mythology of the workplace as something you can get away with. “People are always telling stories, and these stories have a message,” Mr. Federman says. “The message here is, ‘If someone comes after me, I can tear them down. ‘” Management can say, until they are blue in the face, “We have an open environment,” but employees believe they understand the real rules.
4. Telling the patient disturbing news. Afraid about how the patient will react, some caregivers sugar-coat bad news, to the point where the patient doesn’t understand what is being said. “Nothing has been communicated,” Mr. Federman says. At the other extreme, another caregiver may present the news in the most alarming terms, because he is worried about being sued. He thinks giving the worst-case scenario would protect him. Following the directives of risk management programs is important, but unduly frightening patients and their families invites hostility.